In an endoscopic examination of a cavity inside the body, for example a hollow organ, with the aid of a flexible endoscope, an elongate and flexible insertion shaft of the endoscope is inserted through a natural or artificially created opening of the body into the cavity to be examined inside the body. A lens system for generating an endoscopic image is arranged at the distal end of the insertion shaft. To record and convey the endoscopic image from the distal end area (i.e. remote from the observer) of the insertion shaft to a regulator part, which is arranged in a proximal end area (i.e. near the observer) of the shaft, it is possible, for example, for an ordered bundle of light guide fibers to extend inside the shaft. In this case, an endoscopic camera is usually arranged in or on the regulator part, but the regulator part can also have an eyepiece for visual observation. On the other hand, an electronic imaging device can also be arranged in the distal end area of the insertion shaft, and its signals are transmitted to the regulator part via electrical lines extending inside the shaft. The regulator part has a video connection for connecting to an external device for evaluating, displaying and storing the recorded endoscopic image. Moreover, a light-guiding system can be arranged inside the shaft, such that illumination light, coupled in from an external light source via a connection arranged on the regulator part, can be transported to the distal end of the endoscope, where it is used to illuminate the cavity.
It is often necessary to be able to angle the distal end of the shaft in order to make it easier to insert the endoscope through a non-rectilinear channel, to be able to move the tip of the endoscope shaft in a lateral direction inside the cavity, and to be able to change the viewing direction of the lens system arranged in the endoscope tip. For this purpose, the insertion shaft has a controllable portion, in particular a controllable end portion, which can be actively angled in a desired direction and, for this purpose, can be controlled from the direction of the proximal end area of the endoscope. To control the angle of the distal end area of the insertion shaft, suitable operating elements are usually arranged on the regulator part, for example rotary wheels for actuation of wire pulls that extend inside the endoscope shaft and that effect the change of angle. The regulator part is in this case designed as a handpiece which, in addition to the rotary wheels for controlling the deflection of the distal end area of the insertion shaft, comprises further operating elements, such as buttons for operating irrigation and suction valves. The regulator part designed as a handpiece preferably has a supply cable attached to it, which comprises an illumination light guide, a video cable and suction and irrigation lines, and through which these are routed to the corresponding supply devices.
It is also known that the shaft of the flexible endoscope has one or more work channels for the passage of endoscopic work instruments, with which, for example, samples can be collected or surgical manipulations can also be performed inside the cavity. In this case, openings for insertion of the endoscopic work instruments are arranged on the regulator part or in the area of the regulator part.
In an endoscopic examination or operation using a flexible endoscope of this kind, it is often necessary for different movements of the endoscope shaft to be executed alternately or simultaneously. Thus, inserting the insertion shaft into a curved access route not only requires the forward movement of the shaft, it also requires that the distal end area of the insertion shaft is angled in a manner corresponding to the respective curvature of the access route, and, if appropriate, that the insertion shaft is rotated about its longitudinal axis. This applies particularly in the case of an access route that curves several times in different directions, for example the lower and the upper digestive tract. This not only necessitates the angle of the distal end area of the insertion shaft being changed several times and the shaft being rotated several times about its longitudinal axis, it also means that the forward movement occasionally has to be interrupted and the shaft pulled back a short distance in order to obtain an optimal passage through the curving digestive tract and to avoid excessive loading of the walls of the intestine. A forward movement of this kind requires a considerable amount of practice on the part of the operator and, despite this, is often painful for the patient and associated with risks.
EP 1 987 789 A1 discloses an endoscope system comprising a flexible endoscope with an elongate insertion part, and a medical work instrument with a treatment part arranged in a distal area, and a long shaft which is inserted into a channel in the insertion part. The endoscope system further comprises a surgical operating apparatus for entering commands for operating the medical work instrument, a first drive apparatus for driving the treatment part, and a second drive apparatus, which moves the shaft of the medical work instrument to and fro. The surgical operating apparatus comprises an operating lever, with which the motor drives of the medical work instrument can be actuated. For this purpose, the surgical operating apparatus is pushed over the shaft of the endoscope. After the motor drives for actuating the treatment part and for moving the instrument to and fro have been fitted on the endoscope, the shaft of the endoscope is inserted into a cavity inside the body of a patient. In order to collect a tissue sample from the body cavity, the surgeon, by actuating the operating lever, is able to open and close a tissue-removing part of the medical work instrument.
U.S. Pat. No. 6,554,766 B2 discloses an endoscope device which comprises an insertion part with a curvable portion, electric drives for curving the curvable portion, an operation unit for controlling the electric drives, an attachment line for attachment to an external supply unit, a coupling part, and a holding part for holding a holding unit on an operation bed. The operation unit can be fixed on the insertion part and can be held together with the latter in one hand by the surgeon. The operation unit has a convex operating area for controlling the curvable portion of the insertion part, which operating area can be operated by the thumb of the surgeon's hand, and operation switches that can be operated by other fingers. The endoscope can be secured on the operation bed via the holding unit and the holding part. Holding devices for holding a proximal end area of a flexible endoscope are known also from EP 1 859 724 A1 and from U.S. Pat. No. 6,569,084 B1.
To make the insertion of a colonoscopy device easier, US 2007/0135679 A1 proposes fitting a stabilizer in the anus of the patient. The stabilizer has an opening through which the colonoscopy device can be inserted, and a lever for blocking the colonoscopy device relative to the stabilizer.